High-grade osteosarcoma of the extremity: Differences between localized and metastatic tumors at presentation

Gaetano Bacci, Stefano Ferrari, Alessandra Longhi, Cristiana Forni, Marcello Zavatta, Michela Versari, Keith Smith

Research output: Contribution to journalArticle

Abstract

Background: In osteosarcoma, as in other tumors, the presence of metastases at presentation is generally considered a consequence of late diagnosis. To verify this, the authors investigated whether there was a relationship between the stage of the disease at presentation and several clinical and pathologic characteristics, including the interval between the onset of first symptoms or signs and the final diagnosis. Patients and Methods: One thousand seventy-one patients with high-grade osteosarcoma of the extremity were observed between 1980 and 1999. Of these, 891 had a localized tumor and 180 had metastases at the time of diagnosis. Results: Compared with patients with localized disease, patients with detectable metastases at the time of diagnosis had higher serum levels of alkaline phosphatase, larger primary lesions, and tumors often located in the femur and humerus. In terms of time to diagnosis, the interval between the onset of first symptoms and the final diagnosis was significantly shorter in patients with metastases than in patients with localized tumor. This surprising finding probably reflects a more rapid growth of the tumor. Conclusions: These results suggest a different biologic phenotype and aggressiveness of the tumor in a subgroup of patients and that the stage of the disease at presentation depends more on the properties of these tumors than on late diagnosis.

Original languageEnglish
Pages (from-to)27-30
Number of pages4
JournalJournal of Pediatric Hematology/Oncology
Volume24
Issue number1
DOIs
Publication statusPublished - 2002

Keywords

  • Alkaline phosphatase
  • Late diagnosis
  • Localized tumor
  • Long-term survivors
  • Metastases

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Hematology

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